Provider Demographics
NPI:1750302816
Name:ZIMMERING, PAUL H (MD,)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:H
Last Name:ZIMMERING
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BARNES RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1832
Mailing Address - Country:US
Mailing Address - Phone:203-265-3280
Mailing Address - Fax:203-741-6569
Practice Address - Street 1:85 BARNES RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1832
Practice Address - Country:US
Practice Address - Phone:203-265-3280
Practice Address - Fax:203-741-6569
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025507207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001255074Medicaid
CT6024130001Medicare NSC
CT001255074Medicaid
200000855Medicare ID - Type Unspecified